title: Mouse allergen is the major allergen of public health relevance in Baltimore City.
abstract: BACKGROUND
  Cockroach and mouse allergens have both been implicated as causes in inner-city asthma morbidity in multicenter studies, but whether both allergens are clinically relevant within specific inner-city communities is unclear.
  
  
  OBJECTIVE
  Our study aimed to identify relevant allergens in Baltimore City.
  
  
  METHODS
  One hundred forty-four children (5-17 years old) with asthma underwent skin prick tests at baseline and had clinical data collected at baseline and 3, 6, 9, and 12 months. Home settled dust samples were collected at the same time points for quantification of indoor allergens. Participants were grouped based on their sensitization and exposure status to each allergen. All analyses were adjusted for age, sex, and serum total IgE level.
  
  
  RESULTS
  Forty-one percent were mouse sensitized/exposed, and 41% were cockroach sensitized/exposed based on bedroom floor exposure data. Mouse sensitization/exposure was associated with acute care visits, decreased FEV1/forced vital capacity percentage values, fraction of exhaled nitric oxide levels, and bronchodilator reversibility. Cockroach sensitization/exposure was only associated with acute care visits and bronchodilator reversibility when exposure was defined by using bedroom floor allergen levels. Mouse-specific IgE levels were associated with poor asthma health across a range of outcomes, whereas cockroach-specific IgE levels were not. The relationships between asthma outcomes and mouse allergen were independent of cockroach allergen. Although sensitization/exposure to both mouse and cockroach was generally associated with worse asthma, mouse sensitization/exposure was the primary contributor to these relationships.
  
  
  CONCLUSIONS
  In a community with high levels of both mouse and cockroach allergens, mouse allergen appears to be more strongly and consistently associated with poor asthma outcomes than cockroach allergen. Community-level asthma interventions in Baltimore should prioritize reducing mouse allergen exposure.
authors.affiliation: Division of Pediatric Allergy and Immunology, Johns Hopkins School of Medicine, Baltimore, Md.
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Ahluwalia
authors.forename: Roger D
authors.initials: RD
authors.lastname: Peng
authors.forename: Patrick N
authors.initials: PN
authors.lastname: Breysse
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Diette
authors.forename: Jean
authors.initials: J
authors.lastname: Curtin-Brosnan
authors.forename: Charles
authors.initials: C
authors.lastname: Aloe
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Matsui
mesh_terms: D000293:Adolescent; D016902:Air Pollution, Indoor; D000485:Allergens / Q000032:analysis / Q000276:immunology*; D000818:Animals; D001249:Asthma / Q000453:epidemiology / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology*; D015142:Baltimore; D002648:Child; D002675:Child, Preschool; D003058:Cockroaches / Q000276:immunology; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D051379:Mice / Q000276:immunology*; D011634:Public Health; D012882:Skin Tests
chemical_list: D000485:Allergens
keywords: FVC; Feno; Forced vital capacity; Fraction of exhaled nitric oxide; Inner-city asthma; PR; Prevalence ratio; childhood asthma; cockroach allergen; indoor allergens; mouse allergen